Basic Information
Provider Information | |||||||||
NPI: | 1477560852 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ALBRIGHT | ||||||||
FirstName: | REBECCA | ||||||||
MiddleName: | ANN | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | ACSW, LCSW | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 515 BAYOU ST | ||||||||
Address2: |   | ||||||||
City: | VINCENNES | ||||||||
State: | IN | ||||||||
PostalCode: | 475911034 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8128866800 | ||||||||
FaxNumber: | 8128866809 | ||||||||
Practice Location | |||||||||
Address1: | 2007 STATE ST | ||||||||
Address2: |   | ||||||||
City: | WASHINGTON | ||||||||
State: | IN | ||||||||
PostalCode: | 475018505 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8122541558 | ||||||||
FaxNumber: | 8122548308 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/01/2006 | ||||||||
LastUpdateDate: | 11/05/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 149.009438 | IL | N |   | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 34004114A | IN | Y |   | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.